scholarly journals Glossopharyngeal and Hypoglossal Nerve Paralysis Secondary to Prevertebral Phlegmon

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ryunosuke Fukushi ◽  
Izaya Ogon ◽  
Yoshinori Terashima ◽  
Hiroyuki Takashima ◽  
Tsutomu Oshigiri ◽  
...  
Keyword(s):  
Neck Pain ◽  
Hypoglossal Nerve ◽  
Facet Joint ◽  
Retropharyngeal Abscess ◽  
Cervical Region ◽  
Atlantoaxial Joint ◽  
Nerve Paralysis ◽  
Pyogenic Spondylitis ◽  
Signal Changes ◽  
Posterior Pharynx

A 50-year-old man presented to the clinic with severe neck pain, fever, and difficulty breathing and was subsequently admitted to the local orthopedics department with possible retropharyngeal abscess and pyogenic spondylitis. Antibiotic therapy was initiated; however, due to poor oxygenation, he was referred and transferred to our department and admitted. Magnetic resonance imaging showed signal changes at the left C1/2 lateral atlantoaxial joint, posterior pharynx, longus colli muscle, carotid space, and medial deep cervical region, predominantly on the left side. In addition, despite lymph node enlargement from the posterior pharynx to the deep cervical region, there was no abscess formation. There were no signs of a space-occupying lesion or signal changes in the jugular foramen. One day postadmission, the patient’s temperature had risen to 39.1°C and his SpO2 had fallen. His neck pain had also worsened, and emergency surgery was decided. Preoperatively, we suspected retropharyngeal abscess and pyogenic spondylitis. On day 13 postadmission, the patient exhibited dysphagia, deviated tongue protrusion, and the curtain sign. Glossopharyngeal and hypoglossal nerve paralysis were diagnosed. The patient’s swallowing functions recovered and he was discharged on day 36. We experienced a case of glossopharyngeal and hypoglossal nerve paralysis secondary to pyogenic cervical facet joint arthritis.

scholarly journals Retropharyngeal abscess causing grisel’s syndrome secondary to tuberculosis of cervical spine, a rare form of torticollis: case report

2021 ◽  
Vol 7 (5) ◽  
pp. 871
Author(s):  
Reegina Sivarajan ◽  
Mohammad Fuaz Mahfuz ◽  
Siti Hajar Sanudin
Keyword(s):  
Case Report ◽  
Neck Pain ◽  
Neurological Complications ◽  
Retropharyngeal Abscess ◽  
Atlantoaxial Joint ◽  
Neck Movement ◽  
Neck Stiffness ◽  
Rare Type ◽  
Neck Infection ◽  
Grisel’S Syndrome

<p>Grisel’s syndrome is a rare type of non-traumatic subluxation of an atlantoaxial joint characterized by torticollis, neck pain, and reduced neck movement. The common causes of Grisel’s syndrome are head and neck infection or post-otorhinolaryngology (ORL) procedures. We are reporting a case of a 3-year-old boy with a gradual worsening of neck stiffness, neck pain, and restricted neck movement for more than one month. The patient had no history of trauma. The computerized tomographic (CT) showed a retropharyngeal abscess with a bony erosion causing atlantoaxial subluxation. The management and progress of this patient are discussed. The objective of this case report is to emphasize that Grisel’s syndrome should be considered a differential in a painful torticollis to prompt an early diagnosis and treatment to prevent serious neurological complications.</p>

Calcifying pseudoneoplasm of the atlantoaxial joint in a child

2013 ◽  
Vol 18 (4) ◽  
pp. 367-371 ◽  
Author(s):  
Viktor Bartanusz ◽  
Mateo Ziu ◽  
David F. Jimenez ◽  
James M. Henry
Keyword(s):  
Neck Pain ◽  
Facet Joint ◽  
Clinical Manifestations ◽  
Unknown Origin ◽  
Sudden Onset ◽  
Atlantoaxial Joint ◽  
Open Biopsy ◽  
Postoperative Mri ◽  
Adolescents And Adults ◽  
Cervical Segment

Calcifying pseudoneoplasm of the spine is a rare nonneoplastic lesion of unknown origin described in adolescents and adults. Its clinical manifestations include axial pain, myelopathy, or radiculopathy. Surgery is the preferred method of treatment. The authors report the occurrence of calcifying pseudoneoplasm at the C1–2 cervical segment in a 22-month-old child who became completely asymptomatic 2 months after open biopsy. A review of the literature is presented, emphasizing the uniqueness of the presented case in comparison with the previously published cases. The 22-month-old healthy girl presented with sudden onset of neck pain. Due to persistence of the symptoms 2 weeks after onset, imaging studies were performed that revealed an inhomogeneous calcified mass extending from the transverse ligament to the C1–2 interlaminar space and facet joint on the left side. Open biopsy of the mass at the C1–2 lamina was performed. The histological features were consistent with calcifying pseudoneoplasm. The child's neck pain progressively improved and she remained asymptomatic at the 1-year follow-up. The postoperative MRI at 8 months did not reveal any progression of the lesion. Contrary to reported cases, calcifying pseudoneoplasm of the spine may occur as early as 2 years of age and should be included in the differential diagnosis of calcified lesions in this age group. Complete resection is not a prerequisite to clinical improvement when there is no compromise of neural structures; conservative management is appropriate.

Immediate effects of thoracic manipulation on cervical joint position sense in individuals with mechanical neck pain: A randomized controlled trial

2021 ◽  
pp. 1-9
Author(s):  
Emin Ulas Erdem ◽  
Banu Ünver ◽  
Eda Akbas ◽  
Gizem Irem Kinikli
Keyword(s):  
Neck Pain ◽  
Range Of Motion ◽  
Position Sense ◽  
Joint Position Sense ◽  
Position Error ◽  
Cervical Region ◽  
Joint Position ◽  
Cervical Range Of Motion ◽  
Arm Pain ◽  
Neck Function

BACKGROUND: Performing thoracic manipulations for neck pain can result in immediate improvements in neck function. OBJECTIVE: The aim of this study was to investigate the immediate effects of thoracic manipulation on cervical joint position sense and cervical range of motion in individuals with chronic mechanical neck pain. METHODS: Eighty male volunteers between 18–25 years and having chronic or recurrent neck or shoulder pain of at least 3 months duration with or without arm pain were randomized into two groups: Thoracic Manipulation Group (TMG:50) and Control Group (CG:30), with a pretest-posttest experimental design. The TMG was treated with thoracic extension manipulation while the CG received no intervention. Cervical joint position error and cervical range of motion of the individuals were assessed at baseline and 5 minutes later. RESULTS: There was no difference in demographic variables such as age (p= 0.764), Body Mass Index (p= 0.917) and Neck Pain Disability Scale (NPDS) scores (p= 0.436) at baseline outcomes between TMG and CGs. Joint position error outcomes between the two groups following intervention were similar in all directions at 30 and 50 degrees. Differences in range of motion following intervention in neck flexion (p< 0.001) and right rotation (p= 0.004) were higher in TMG compared to CG. CONCLUSIONS: A single session of thoracic manipulation seems to be inefficient on joint position sense in individuals with mild mechanical neck pain. However, thoracic manipulation might be an effective option to increase flexion and rotation of the cervical region as an adjunctive to treatment.

scholarly journals SAT0547 RADIOGRAPHIC IMAGING IN ASSESSMENT OF FLUOROSCOPIC GUIDED INJECTION OF RHEUMATOID ATLANTOAXIAL JOINT INFLAMMATION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1230.1-1231
Author(s):  
D. Fouad ◽  
S. Rashad ◽  
M. Ghaly ◽  
M. Hassanien
Keyword(s):  
Rheumatoid Arthritis ◽  
Neck Pain ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Steroid Injection ◽  
Therapeutic Option ◽  
Control Group ◽  
Atlantoaxial Joint ◽  
Post Intervention

Background:Rheumatoid spondylitis is a feature of long-lasting Rheumatoid arthritis (RA) that is presented by neck pain, headache and sleep disturbance. Atlantoaxial joint (AAJ) is the commonest cervical spine joint that affected in patients with RA. When it is involved, it can be associated with dangerous complications. Magnetic Resonance Imaging (MRI) can be used for assessing the disease activity, the amount of cartilage destruction, associated cervical myelopathy and differentiating synovial fluid from inflammatory pannus (Taniguchi D, et al., 2008).Objectives:This study aimed to evaluate the efficacy of intra-articular steroid injection of inflamed AAJ in RA patients, regarding neck pain, headache and sleep quality using pre and post-interventions MRI.Methods:A prospective case control study. Patients with inflamed AAJ were recruited. Group 1 (AAJ group, n = 30), received intraarticular AAJ steroid injection, guided by fluoroscopy and Group 2 (control group, n = 30), received systemic steroids. Both groups were assessed with: Visual Analogue scale (VAS) for nocturnal neck pain and headache. Pittsburgh sleep quality index (PSQI) was used for sleep disturbance. Pre and post contrasts enhanced MRI interventions were done for both groups during the period of follow up (three months).Results:Nocturnal neck pain, headache and sleep disturbance have significantly decreased, during follow up visits (3 months), in AAJ group in comparison to the control group. The Pre-intervention nocturnal pain score was 60.3 ±17.1 in AAJ group & 58.5 ±17.9 in control group. Pain has significantly decreased after 2weeks in AAJ group with continuous improvement till 3 months’ post-intervention 6.9 ±4.65 & 51.26 ±10.54 respectively. The pre-intervention headache was 22.68 ±16.74 in AAJ group & 45.17 ±15.83 in control group decreased to 7.54 ±5.23 & 48.52 ±11.98 respectively post intervention. The percentage of patients who had sleep disturbance at baseline was 66.7% & 73.3% in AAJ and control groups respectively which has significantly decreased to 6.7% & 43.3% after 3 months. Regarding MRI, AAJ group hada statistical significant decreasein the percentage of patients with MRI synovial enhancement, inflammatorypannus,fibrosis and bone marrow edema in comparison to control group 3 months post intervention. All post-procedural side effects resolved within thmonth without further medical intervention, and no long-term sequelae were identifiedConclusion:Fluoroscopic guided intra-articular steroid injection of inflamed atlantoaxial joints is considered a beneficial therapeutic option in rheumatoid arthritis patients regarding clinical and radiological assessments.References:[1]Taniguchi D, Tokunaga D, Hase H, et al. Evaluation of lateral instability of AAJ in RA using dynamic open-mouth view radiographs. Clin Rheumatol.2008 Jul. 27(7):851-7.Disclosure of Interests:None declared

Isolated Hypoglossal Nerve Paralysis

2014 ◽  
Vol 127 (10) ◽  
pp. 926-927 ◽  
Author(s):  
Yu-Guang Chen ◽  
Ming-Shen Dai ◽  
Ching-Liang Ho ◽  
Tzu-Chuan Huang
Keyword(s):  
Hypoglossal Nerve ◽  
Nerve Paralysis

scholarly journals The Midterm Surgical Outcome of Modified Expansive Open-Door Laminoplasty

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Kuang-Ting Yeh ◽  
Ru-Ping Lee ◽  
Ing-Ho Chen ◽  
Tzai-Chiu Yu ◽  
Cheng-Huan Peng ◽  
...  
Keyword(s):  
Neck Pain ◽  
Facet Joint ◽  
Japanese Orthopaedic Association ◽  
Neck Disability Index ◽  
Standard Technique ◽  
Invasive Technique ◽  
Open Door ◽  
Gradual Improvement ◽  
Less Invasive

Laminoplasty is a standard technique for treating patients with multilevel cervical spondylotic myelopathy. Modified expansive open-door laminoplasty (MEOLP) preserves the unilateral paraspinal musculature and nuchal ligament and prevents facet joint violation. The purpose of this study was to elucidate the midterm surgical outcomes of this less invasive technique. We retrospectively recruited 65 consecutive patients who underwent MEOLP at our institution in 2011 with at least 4 years of follow-up. Clinical conditions were evaluated by examining neck disability index, Japanese Orthopaedic Association (JOA), Nurick scale, and axial neck pain visual analog scale scores. Sagittal alignment of the cervical spine was assessed using serial lateral static and dynamic radiographs. Clinical and radiographic outcomes revealed significant recovery at the first postoperative year and still exhibited gradual improvement 1–4 years after surgery. The mean JOA recovery rate was 82.3% and 85% range of motion was observed at the final follow-up. None of the patients experienced aggravated or severe neck pain 1 year after surgery or showed complications of temporary C5 nerve palsy and lamina reclosure by the final follow-up. As a less invasive method for reducing surgical dissection by using various modifications, MEOLP yielded satisfactory midterm outcomes.

scholarly journals The Effectiveness of Remote Exercise Training to an Individual with Chronic Neck Pain: A Case Report

2021 ◽  
Vol 5 (1) ◽  
pp. 10-13
Author(s):  
Abdurahim Aslıyüce ◽  
◽  
, Özlem Ülger ◽  
Keyword(s):  
Quality Of Life ◽  
Exercise Training ◽  
Neck Pain ◽  
Grip Strength ◽  
Working Hours ◽  
Chronic Neck Pain ◽  
Cervical Region ◽  
Spinal Stabilization ◽  
Surgical Nurses

Neck pain is a very common problem that creates a socio-economic burden. One of the most common causes of neck pain is disc herniation and often causes the pain to become chronic. Factors such as poor posture, long working hours, and psychological stress exacerbate the symptoms related to the cervical region. Surgical nurses are also at high risk for neck pain. Also, due to the Covid-19 pandemic, many patients, especially healthcare professionals, cannot access physiotherapy and rehabilitation services both due to their busy work and to reduce the risk of contamination. Therefore, this study aimed to examine the effectiveness of remote spinal stabilization exercises in a patient with chronic neck pain. Pain, disability, kinesophobia, grip strength, and quality of life of a 26-year-old female patient who was an operating room nurse were evaluated. Architectural features of the muscles were evaluated by ultrasonography. 3 days a week, 5 weeks of distance exercise training was given. As a result, it was observed that pain, kinesiophobia, and disability levels decreased, quality of life and grip strength increased in this case. M. Longus Colli thickness was found to be increased. Also, the patient stated that her symptoms were reduced and she was less tired at work. This study is the first to provide remote exercise training for a surgical nurse with chronic neck pain. It is thought that the results of this study will shed light on more comprehensive studies on surgical nurses.

scholarly journals Posterior Ligamentous Complex Reconstruction for Cervical Dislocation and Instability in Patients without Vertebral Fracture with Artificial Ligaments: A Technical Note

2020 ◽  
Author(s):  
Chengyi Huang ◽  
Beiyu Wang ◽  
Hao Liu ◽  
Tingkui Wu ◽  
Kangkang Huang ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Vertebral Fracture ◽  
Neck Pain ◽  
Facet Joint ◽  
Spinous Process ◽  
Posterior Ligamentous Complex ◽  
Reconstruction Surgery ◽  
Artificial Ligaments ◽  
Cervical Surgery ◽  
Patient Reported

Abstract Introduction: The posterior ligamentous complex (PLC) offers restraints to deformation in a complex and interconnected manner. The stability and range of motion (ROM) of the posterior cervical spine is greatly restricted when the PLC is damaged, even without bone disruptions. We describe a novel surgical technique, its advantages, and the postoperative condition of the first patient to use artificial ligament in a reconstruction surgery of PLC injuries in patients without lower cervical vertebral fracture. This technique aimed to fully retain the mobility of the injured segment based on spinal stability and apply dynamic reconstruction in patients’ treatment.Method: We present a detailed description of the reconstruction surgery with artificial ligaments performed on C4-6 PLC injuries in a 27-year-old male presented with neck pain and restricted movement following a high fall injury accompanied by impaired movement of limbs. Results: Immediately postsurgery, the patient’s neck pain and quadriparesis had been improved. The spinal canal decompression and cervical spine sequence results were satisfactory, the facet joint face was in a good position, and the spinous process spacing returned to normal. After three months of rehabilitation, the patient reported improvement of symptoms and the physical and imaging examination showed a significant improvement in the patient’s condition. The patient’s neck mobility motor function had improved further.Conclusion: The present data demonstrate that the novel technique for reconstruction of PLC injury is feasible and safe. However, familiarity with cervical anatomy and adequate experience in lateral mass screws placement during surgery is crucial for this procedure. Therefore, a highly experienced cervical surgery team is recommended to perform the surgery.

scholarly journals Unstable odontoid fractures: technical appraisal of anterior extrapharyangeal open reduction internal fixation for irreducible unstable odontoid fractures. Patient series

2021 ◽  
Vol 2 (20) ◽  
Author(s):  
Sushil Patkar
Keyword(s):  
Open Reduction ◽  
Facet Joint ◽  
Open Reduction Internal Fixation ◽  
Atlantoaxial Instability ◽  
Rigid Fixation ◽  
Atlantoaxial Joint ◽  
Fracture Fragment ◽  
Odontoid Fractures ◽  
Atlantoaxial Fixation ◽  
Displaced Fracture

BACKGROUND Displaced odontoid fractures that are irreducible with traction and have cervicomedullary compression by the displaced distal fracture fragment or deformity caused by facetal malalignment require early realignment and stabilization. Realignment with ultimate solid fracture fusion and atlantoaxial joint fusion, in some situations, are the aims of surgery. Fifteen such patients were treated with direct anterior extrapharyngeal open reduction and realignment of displaced fracture fragments with realignment of the atlantoaxial facets, followed by a variable screw placement (VSP) plate in compression mode across the fracture or anterior atlantoaxial fixation (transarticular screws or atlantoaxial plate screw construct) or both. OBSERVATIONS Anatomical realignment with rigid fixation was achieved in all patients. Fracture fusion without implant failure was observed in 100% of the patients at 6 months, with 1 unrelated mortality. Minimum follow-up has been 6 months in 14 patients and a maximum of 3 years in 4 patients, with 1 unrelated mortality. LESSONS Most irreducible unstable odontoid fractures can be anatomically realigned by anterior extrapharyngeal approach by facet joint manipulation. Plate (VSP) and screws permit rigid fixation in compression mode with 100% fusion. Any associated atlantoaxial instability can be treated from the same exposure.

Sign in / Sign up

Export Citation Format

Share Document